ComplaintsforMercycare Health Plans
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Complaint Details
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Initial Complaint
01/03/2022
- Complaint Type:
- Billing Issues
- Status:
- Answered
I paid cash for my flu shot a third party was used to not pay it. Saying a discount card was used saving me $15Business response
01/06/2022
MercyCare has completed its investigation regarding your customer's concern. The customer (our member) went to a pharmacy to receive a flu shot. The pharmacy processed the claim with a discount card instead of using our member's medical/pharmacy insurance card. The balance was then submitted to our pharmacy benefit manager and the claim was denied as not payable due to a discount card was used. Had the claim been processed under their MercyCare medical/pharmacy insurance card, the member would have had a zero dollar liability.
MercyCare contacted the pharmacy and they were unable to reverse the claim and process the claim under the member's medical/pharmacy insurance card. Therefore, MercyCare will make an exception and issue the member a check in the amount indicated on the prescription receipt. Please advise the member that in the future, they must use their medical/pharmacy insurance card prior to using a discount card or the same result will occur.
Respectfully,
***********************
Director of Claims/Customer Service
**********************
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Customer Complaints Summary
1 total complaints in the last 3 years.
0 complaints closed in the last 12 months.